Jaafarpour Molouk, Vasigh Aminolah, Khajavikhan Javaher, Khani Ali
Lecturer, Department of Midwifery, Nursing and Midwifery Faculty, Ilam University of Medical Science, Ilam, IR-Iran.
Assistant Professor, Department of Anaesthesiology, Medicine Faculty, Ilam University of Medical Science, Ilam, IR-Iran.
J Clin Diagn Res. 2017 Mar;11(3):UC04-UC07. doi: 10.7860/JCDR/2017/21437.9434. Epub 2017 Mar 1.
Pain is the key concern of women after caesarean delivery that may interfere with breastfeeding.
The aim of this study was to assess effect of ketofol (ketamine/propofol combination) on pain and complication after caesarean delivery under spinal anaesthesia.
In this randomized double-blind clinical trial, 92 parturient scheduled for elective caesarean delivery under spinal anaesthesia were included. The simple random sampling method was used to place subjects in four groups of ketamine (0.25 mg/kg), propofol (0.25 mg/kg), ketofol (25 mg ketamine plus 25 mg propofol) and placebo (saline). The drugs were administered intravenously immediately after clamping the umbilical cord. Visual Analog Scale (VAS) was used to determine the intensity of pain. Complications after surgery including shivering, nausea and vomiting as well as onset of breastfeeding were recorded.
The mean score of pain, morphine consumption and time of breastfeeding in the ketofol group were significantly lower than other groups at various intervals (p<0.05, p<0.001). The frequencies of shivering, nausea, vomiting, retention and pruritus in the ketofol group were significantly lower than other groups (p<0.001, p<0.05).
The effective role of ketofol on reducing pain and complication after caesarean delivery indicated that it can be considered as a safe and alternative drug in these patients.
疼痛是剖宫产术后女性的关键问题，可能会干扰母乳喂养。
本研究旨在评估氯胺酮丙泊酚合剂（氯胺酮/丙泊酚组合）对腰麻下行剖宫产术后疼痛及并发症的影响。
在这项随机双盲临床试验中，纳入了92例计划在腰麻下行择期剖宫产的产妇。采用简单随机抽样方法将受试者分为四组，分别给予氯胺酮（0.25mg/kg）、丙泊酚（0.25mg/kg）、氯胺酮丙泊酚合剂（25mg氯胺酮加25mg丙泊酚）和安慰剂（生理盐水）。在钳夹脐带后立即静脉给药。采用视觉模拟评分法（VAS）确定疼痛强度。记录术后并发症，包括寒战、恶心、呕吐以及母乳喂养开始时间。
氯胺酮丙泊酚合剂组在不同时间段的疼痛平均评分、吗啡用量和母乳喂养时间均显著低于其他组（p<0.05，p<0.001）。氯胺酮丙泊酚合剂组的寒战、恶心、呕吐、尿潴留和瘙痒发生率显著低于其他组（p<0.001，p<0.05）。
氯胺酮丙泊酚合剂在减轻剖宫产术后疼痛及并发症方面的有效作用表明，它可被视为这些患者的一种安全替代药物。
